Mortality risk after herpes zoster infection in end-stage renal disease patients

John H. Ahn, Jennifer L. Waller, Stephanie L. Baer, Rhonda E. Colombo, Mufaddal F. Kheda, N. Stanley Nahman, Jake E. Turrentine

Research output: Contribution to journalArticle

Abstract

Background End-stage renal disease (ESRD) patients have increased risk of developing herpes zoster (zoster) compared with the general population, but mortality risk is unknown. We assessed the risk of mortality in hospitalized ESRD patients with a diagnosis of zoster from the inpatient hospital files (as opposed to outpatient records) of the United States Renal Data System. Methods This study analyzed incident ESRD patients from 2006 to 2009. Based on an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of zoster infection, we determined 2-year mortality following an inpatient diagnosis. Cox proportional hazards models were used to examine the association of mortality and zoster, when controlling for demographic and other clinical risk factors. Results Zoster was diagnosed in 2784 patients, 51% of whom died within 2 years, with a mean time to death of 8.1 months. Patients who died were more likely to be white and older, score higher on the Charlson Comorbidity Index (CCI) and have other clinical diagnoses besides CCI. Increased risk of death within 2 years was associated with older age (adjusted hazard ratio 1.03), malnutrition (1.31), bacteremia/septicemia (1.16) and increasing CCI (1.10). Zoster vaccine was administered to 27 patients, but the small number precluded analysis of its impact. Conclusions Mortality in ESRD patients with an inpatient zoster diagnosis is increased with older age and higher severity of clinical comorbidities. The role of zoster vaccination on mortality in this population remains to be defined.

Original languageEnglish (US)
Pages (from-to)101-105
Number of pages5
JournalClinical Kidney Journal
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Herpes Zoster
Chronic Kidney Failure
Mortality
Infection
Comorbidity
Inpatients
Herpes Zoster Vaccine
International Classification of Diseases
Bacteremia
Proportional Hazards Models
Information Systems
Malnutrition
Population
Sepsis
Vaccination
Outpatients
Demography
Kidney

Keywords

  • United States Renal Data System
  • dialysis
  • herpes zoster
  • mortality
  • risk factors

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Mortality risk after herpes zoster infection in end-stage renal disease patients. / Ahn, John H.; Waller, Jennifer L.; Baer, Stephanie L.; Colombo, Rhonda E.; Kheda, Mufaddal F.; Nahman, N. Stanley; Turrentine, Jake E.

In: Clinical Kidney Journal, Vol. 12, No. 1, 01.01.2019, p. 101-105.

Research output: Contribution to journalArticle

Ahn, John H. ; Waller, Jennifer L. ; Baer, Stephanie L. ; Colombo, Rhonda E. ; Kheda, Mufaddal F. ; Nahman, N. Stanley ; Turrentine, Jake E. / Mortality risk after herpes zoster infection in end-stage renal disease patients. In: Clinical Kidney Journal. 2019 ; Vol. 12, No. 1. pp. 101-105.
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abstract = "Background End-stage renal disease (ESRD) patients have increased risk of developing herpes zoster (zoster) compared with the general population, but mortality risk is unknown. We assessed the risk of mortality in hospitalized ESRD patients with a diagnosis of zoster from the inpatient hospital files (as opposed to outpatient records) of the United States Renal Data System. Methods This study analyzed incident ESRD patients from 2006 to 2009. Based on an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of zoster infection, we determined 2-year mortality following an inpatient diagnosis. Cox proportional hazards models were used to examine the association of mortality and zoster, when controlling for demographic and other clinical risk factors. Results Zoster was diagnosed in 2784 patients, 51{\%} of whom died within 2 years, with a mean time to death of 8.1 months. Patients who died were more likely to be white and older, score higher on the Charlson Comorbidity Index (CCI) and have other clinical diagnoses besides CCI. Increased risk of death within 2 years was associated with older age (adjusted hazard ratio 1.03), malnutrition (1.31), bacteremia/septicemia (1.16) and increasing CCI (1.10). Zoster vaccine was administered to 27 patients, but the small number precluded analysis of its impact. Conclusions Mortality in ESRD patients with an inpatient zoster diagnosis is increased with older age and higher severity of clinical comorbidities. The role of zoster vaccination on mortality in this population remains to be defined.",
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